Time to development of macrovascular complications and its predictors among type 2 diabetes mellitus patients at Jimma University Medical Center

• Published in: BMC endocrine disorders 2024-11, Vol.24 (1), p.252-15, Article 252
• Main Authors: Adare, Abera Feyisa, Tiyare, Firew Tiruneh, Marine, Buzuneh Tasfa
• Format: Article
• Language: English
• Subjects: Academic Medical Centers; Adult; Aged; Analysis; Blood cholesterol; Blood vessels; Cardiovascular disease; Cardiovascular diseases; Cerebrovascular disease; Cholesterol; Complications and side effects; Coronary vessels; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Diabetic Angiopathies - epidemiology; Diabetic Angiopathies - etiology; Dyslipidemia; Ethiopia; Female; Follow-Up Studies; Health care; Health care reform; Heart failure; Hemoglobin; High density lipoprotein; Humans; Hypertension; Hypoglycemic agents; Insulin; Male; Medical centers; Medical research; Medicine, Experimental; Metabolic disorders; Middle Aged; Morbidity; Mortality; Patients; Predictor; Prognosis; Public health; Quality of life; Retrospective Studies; Risk Factors; Survival; Survival analysis; Time Factors; Time to macrovascular complications; Triglycerides; Type 2 diabetes; Type 2 diabetes mellitus; Vein & artery diseases
• ISSN: 1472-6823; 1472-6823
• DOI: 10.1186/s12902-024-01782-3

Type 2 diabetes mellitus is a serious metabolic disease that is often associated with vascular complications. The increasing prevalence of type 2 diabetes mellitus poses significant public health challenges, particularly in Low and Middle-Income Countries where healthcare resources are often limited. In Africa, the burden of T2DM is rising rapidly, leading to a consequential increase in macrovascular complications such as cardiovascular disease and stroke. These complications not only affect the quality of life but also significantly contribute to morbidity and mortality among affected individuals. The main objective of this study was to assess the time to development of macrovascular complications and identify its predictors among type 2 diabetes mellitus patients in Jimma University medical center from 2018-2022. Institutional-based retrospective follow-up study was conducted in Jimma University Medical Center among newly diagnosed type 2 diabetes mellitus patient from 2018, to 2022. A systematic sampling technique was used to recruit 452 records of type 2 diabetes mellitus patients. The Kaplan-Meier curve and the log-rank tests were used to determine the time to macro-vascular complications, and evaluate the significant difference in survival probability among predictors respectively. The overall goodness of the Cox proportional hazard model was checked by Cox-Snell residuals. Bivariable and multivariable cox-proportional hazard regression were used to identify the association between the variables and survival time. The median survival time to development of macro vascular complications was 24 months. Urban residence [(Adjusted hazard ratio = 2.02; 95% CI: (1.33, 3.05)], having hypertension at start of diabetic treatment [(AHR = 1.52; 95% CI: (1.06, 2.13)], baseline age ≥ 60 years [(AHR = 4.42; 95% CI: (1.72, 11.29)], having dyslipidemia at baseline [(AHR = 1.82; 95% CI: (1.13, 2.93)], High density lipoprotein cholesterol levels  150 mg/dl [(AHR = 1.48; 95% CI:( 1.02, 2.13)], Hemoglobin A1C level > 7% [(AHR = 1.49; 95% CI: (1.04, 2.14)], and Oral hypoglycemic agents + insulin [(AHR = 2.73; 95% CI: (1.81, 4.09)] were the significant predictors of the time to development of macro vascular complications. Findings in this study indicated that the median time to development of macro vascular complications among type 2 diabetes mellitus patients was 24 months. Baseline age category in years, residence, p